PURPOSE: We report an unusual case of presumptive diagnosis of herpes-induced anterior uveitis with acute hypopyon after trauma. CASE SUMMARY: A 82-year-old male was diagnosed with herpes keratitis due to dendritic keratitis in the left eye, and the lesion disappeared after antiviral treatment. However, 1 year later, the patient visited again with visual loss, pain, and tearing of the left eye after trauma. At the examination, best-corrected visual acuity was counting fingers and the intraocular pressure was 27 mmHg in the left eye. Slit-lamp examination revealed corneal epithelial erosion, moderate corneal edema, and prominent inflammation with 2 mm high hypopyon in the anterior chamber. We thought that bacterial endophthalmitis had rapidly progressed after trauma, so we performed bacterial cultures and an intravitreal antibiotics injection. Considering the clinical manifestations of lesions and herpes keratitis in the past, we could not exclude herpes virus infection. Cultures were negative and the symptoms improved, so the antiviral treatment was gradually reduced and stopped at 2 months. However, recurrence was observed on day 5 after stopping antiviral therapy. We therefore assumed that recurrent herpes virus caused anterior uveitis, and then, antiviral and steroid therapy was resumed. The patient subsequently showed improvement in his symptoms and recovered his visual acuity. CONCLUSIONS: When acute hypopyon is observed in the anterior chamber after trauma, not only bacterial iritis and endophthalmitis but also viral-induced anterior uveitis should be considered in the differential diagnosis.
Aged, 80 and over ; Anterior Chamber ; Anti-Bacterial Agents ; Corneal Edema ; Diagnosis ; Diagnosis, Differential ; Endophthalmitis ; Fingers ; Humans ; Inflammation ; Intraocular Pressure ; Iritis ; Keratitis ; Keratitis, Dendritic ; Male ; Recurrence ; Simplexvirus ; Tears ; Uveitis, Anterior ; Visual Acuity

PURPOSE: We report a case of spontaneous recovery of an iris cyst with only tuberculosis medication and conservative eye drops when uveitis and angle closure occurred because of a cyst in a patient with peritoneal tuberculosis. CASE SUMMARY: A 49-year-old female who was diagnosed with iritis and treated with steroid eye drops visited our clinic because of decreased visual acuity 1 month prior. There were anterior chamber inflammation cells and an iris cyst completely obstructing the anterior chamber at 12 o'clock. At the time, the patient had been diagnosed with peritoneal tuberculosis in the Department of Internal Medicine and Gynecology and had been treated with surgery and medication. The patient had no past history of glaucoma, but when the iris cyst developed, the intraocular pressure increased to 29 mmHg and anterior inflammatory cells were seen in the range of +1 to +2. The primary lesion of tuberculosis improved and the iris cyst disappeared with treatments involving medication for tuberculosis, steroid eye drops, and glaucoma eye drops, without invasive treatments such as alcohol curettage, laser treatment, or cyst resection. CONCLUSIONS: If an iris cyst is a new lesion of the eye, it is necessary to identify the pattern and cause of the iris cyst first, and if a secondary benign iris cyst is suspected, the primary treatment of the causative disease is necessary rather than prompt invasive treatment.
Anterior Chamber ; Curettage ; Female ; Glaucoma ; Gynecology ; Humans ; Inflammation ; Internal Medicine ; Intraocular Pressure ; Iris ; Iritis ; Middle Aged ; Ophthalmic Solutions ; Peritonitis, Tuberculous ; Tuberculosis ; Uveitis ; Visual Acuity

BACKGROUND/AIMS: Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), has been reported to have various ophthalmologic manifestations. The aim of this study was to evaluate the prevalence of ophthalmologic manifestations associated with IBD in Korea. METHODS: Sixty-one patients were examined between May 2013 and October 2014. We performed complete ophthalmologic examinations. RESULTS: Findings included 36 patients with CD and 25 with UC. The mean age of the patients was 34±16 years and disease duration was 45.3±23.9 months. Ophthalmologic manifestations were positive in 44 cases. Primary complication was diagnosed in 5 cases, as follows; iritis in 2 cases, episcleritis in one case, iritis with optic neuritis in 1 case, and serous retinal detachment in 1 case, without secondary complications. The most common coincidental complication was dry eye syndrome (DES), in 35 patients (57.4%). The prevalence of DES in the control group was 21.3%. The proportion of DES in patients with IBD was significantly higher than in the control group (P=0.002). CONCLUSIONS: Ophthalmologic manifestations were high (72.1%) in IBD patients. Clinically significant primary ocular inflammation occurred in 8.2% of patients. The most common complication was DES. There was a higher rate of DES in patients with IBD compared to the control group. Evaluation of the eye should be a routine component in patients with IBD.
Colitis, Ulcerative ; Crohn Disease ; Dry Eye Syndromes ; Humans ; Inflammation ; Inflammatory Bowel Diseases* ; Iritis ; Korea ; Ophthalmology ; Optic Neuritis ; Prevalence ; Retinal Detachment ; Scleritis

Rheumatic diseases are associated various extra-articular manifestations, such as eye, nerve, pericardium, and pleura. The anterior part of the eye has distinguished anatomic structure resembling synovial joints, thus it is a common site of ocular manifestation in rheumatic disease. These changes include sicca syndrome, peripheral ulcerative keratitis, episcleritis, scleritis, and iritis. Some of these findings may be the clues for the diagnosis of the rheumatic diseases, and some ocular manifestations may represent the activity or prognosis of the rheumatic diseases. These ocular complications may leads to severe visual loss. It is crucial to rule out underlying systemic diagnosis in rheumatic disease associated ocular diseases, and when diagnosed, the coordination of the rheumatologist with the ophthalmologist in the treatment is imperative.
Corneal Ulcer ; Diagnosis ; Eye Diseases* ; Iritis ; Joints ; Pericardium ; Pleura ; Prognosis ; Rheumatic Diseases* ; Scleritis ; Sjogren's Syndrome

Adult ; Bloodletting ; Ear ; blood supply ; Female ; Humans ; Iritis ; therapy ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

PURPOSE: To report a case of intraocular cilium revealed by diagnostic vitrectomy in a case of stubborn uveitis that was unresponsive to steroid therapy. CASE SUMMARY: A 39-year-old man was referred to our hospital due to decreased vision in his right eye that started two months prior to presentation. He had previously been treated for a diagnosis of iridocyclitis. The patient's history revealed a blunt trauma to the right eye while wearing glasses after which he developed a microhyphema and was treated for traumatic iritis at another clinic 3 months ago. He was treated with topical and oral steroids after being diagnosed with iridocyclitis and had recently been prescribed additional oral cyclosporine because his condition had not improved. Ocular examination revealed inflammatory cells in the anterior chamber and vitreous cavity with hand motion vision. Ultrasonography revealed a hazy vitreous cavity but the retina was flat. Diagnostic vitrectomy with intravitreal antibiotic injection was performed and an intraocular foreign body presumed as a cilium was detected without an entrance wound on the exterior or interior surface of the eye. After removal of the foreign body, the patient's vision was completely recovered. CONCLUSIONS: In cases of chronic uveitis that do not respond to immunosuppressive treatment without a clearly definable cause, diagnostic vitrectomy should be considered, keeping in mind the possibility of intraocular foreign body.
Adult ; Anterior Chamber ; Cilia ; Cyclosporine ; Endophthalmitis ; Eye ; Eyeglasses ; Foreign Bodies ; Glass ; Hand ; Humans ; Iridocyclitis ; Iritis ; Retina ; Steroids ; Uveitis ; Vision, Ocular ; Vitrectomy

PURPOSE: To report a patient with herpes zoster ophthalmicus in whom hyphema, glaucoma and external ophthalmoplegia occurred. CASE SUMMARY: A 59-year-old male patient developed severe ocular pain and decreased visual acuity in his left eye 10 days ago. He had been diagnosed as herpes zoster ophthalmicus 14 days before and given antiviral agent. He could not percept light. His left eye showed hyphema, severe exudative iritis and elevated IOP. Lid drooping and complete external ophthalmoplegia were present in the left eye. Systemic corticosteroid with concomitant antiviral agents and antiglaucomatous agents was administered. RESULTS: Light perception did not recover and phthisis bulbi developed in his left eye at 2 months after the onset of the skin lesion. The patient showed gradual improvement in movement of the lid and external ocular muscle.
Antiviral Agents ; Glaucoma* ; Herpes Zoster Ophthalmicus* ; Herpes Zoster* ; Humans ; Hyphema* ; Iritis ; Male ; Middle Aged ; Ophthalmoplegia* ; Skin ; Visual Acuity

PURPOSE: To evaluate the clinical results of 6 mm iris-fixated phakic intraocular lens (Artisan(R) lens) implantation in myopic patients. METHODS: Forty eyes of 23 myopic patients underwent 6-mm Artisan(R) phakic IOL implantation and were followed-up for over 6 months. We prospectively analyzed the efficacy, stability, predictability, change of astigmatism, endothelial cell count, pupil diameter, degree of decentration, subjective satisfaction and complications. RESULTS: The preoperative mean spherical equivalent was -9.46 D, and postoperative spherical equivalent was -0.70D at 1 month, -0.55D at 3 months, -0.54D at 6 months, -0.78D at 12 months and remained stable during the follow-up period. The preoperative mean astigmatism was -1.88D and postoperative astigmatism was -0.87D at 6 months. Postoperative uncorrected visual acuity (UCVA) was more than 0.8 in 85% of the eyes at 1 month, 91% at 3 months, 95% at 6 months, and 89% at 12 months. The spherical equivalent refraction after surgery was within 1.0D of emmetropia in 78% of eyes at 1 month, 80% at 3 months, 88% at 6 months, and 64% at 12 months. There was no significant decrease in the endothelial cell count during the follow-up period. Preoperative scotopic pupil diameters were significantly decreased at 1 month and the mean decentration of the lens was 0.38 mm. Patient satisfaction was generally high. Complications included the transient elevation of intraocular pressure in 1 eye, corneal edema in 4 eyes, iritis in 1 eye, traumatic dislocation in 1 eye and iris atrophy in 2 eyes. CONCLUSIONS: The 6-mm Artisan(R)phakic IOL implantation may be an effective surgical procedure for myopic patients who cannot undergo corneal refractive surgery, as it provided good visual results, predictability, patient satisfaction, and short-term safety.
Astigmatism ; Atrophy ; Corneal Edema ; Dislocations ; Emmetropia ; Endothelial Cells ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Iris ; Iritis ; Patient Satisfaction ; Phakic Intraocular Lenses ; Prospective Studies ; Pupil ; Refractive Surgical Procedures ; Visual Acuity

Recurrent iritis and oral/genital ulcers have been described for the first time as a separate pathological entity by the Turkish dermatologist Hulusi Behcet. Behcet disease is a chronic, multi-systemic disorder, which affects many organs as a result of vasculitis. The clinical manifestations are divided into two groups: major (oral ulcers, eye lesions, genital ulcerations, and skin lesions) and minor (arthritis, gastrointestinal lesions, epididymitis, thrombophlebitis, and central nervous system involvement) criteria. The incidence of hearing loss in Behcet disease has been reported as 12% to 80% in several studies. A 37-year-old man diagnosed as Behcet disease was admitted to our department with complaints of profound right hearing loss and dizziness. He was treated with steroid without improvement. After one year, he suffered from complete hearing loss on the left side. A temporal bone CT scan revealed right cochlear ossification. Cochlear implantation was performed within 4 weeks after the completion of steroid therapy in the left cochlea, which was partially obstructed by fibrotic tissue. However, the electrode was fully inserted without resistance. Wound healing complications were not encountered in the postoperative period. The hearing threshold was restored to 30 dBHL, while speech discrimination did not improve as much as expected. We propose that the routine hearing examinations be employed in the evaluation and management of Behcet disease. According to our experience, we find that cochlear implantation should be carried out at an early stage, before the development of labyrinthine ossification.
Adult ; Behcet Syndrome* ; Central Nervous System ; Cochlea ; Cochlear Implantation* ; Cochlear Implants* ; Deafness ; Dizziness ; Electrodes ; Epididymitis ; Hearing ; Hearing Loss ; Humans ; Incidence ; Iritis ; Male ; Postoperative Period ; Skin ; Speech Perception ; Temporal Bone ; Thrombophlebitis ; Tomography, X-Ray Computed ; Ulcer ; Vasculitis ; Wound Healing

The vascular involvement is seen in 8% to 24% of patients with Behçet's syndrome. Arterial lesions are less frequently observed and the involvement of renal artery is very rare. Indeed, there is only one case report of ruptured renal aneurysm due to Behc et's disease. We report a case of renal artery rupture, which was likely caused by Behçet's disease. Even though we cannot completely rule out the other causes of renal artery rupture with this patient, the rupture was likely due to vascular involvement of Behçet's disease. Dermatologists always should consider the possibility of major vessel involvement when they treat patients with Behçet's disease, even if the incidence is very low and the patient may not complain of any systemic symptoms. INTRODUCTION: Behçet's disease was first defined by Hulusi Behçet's in 1937 as a multisystemic disease with the triad of recurrent aphthous stomatitis, genital ulceration and relapsing iritis. Its etiology remains obscure. It is accepted that the pathologic process of Behçet's disease is an immunologic vasculitis. Among vascilar lesions, the venous system is the major affected site. Arterial lesions, such as aneurysms or occlusions, are rarely reported, but sometimes adversely affects the course of the disease. Aneurysm formation is known to be life-threatening because of the risk of rupture.
Aneurysm ; Humans ; Incidence ; Iritis ; Renal Artery* ; Rupture* ; Stomatitis, Aphthous ; Ulcer ; Vasculitis